Thousands of Pennsylvanians poke themselves each day with needles and lancets to treat or test for medical conditions such as diabetes, hepatitis and multiple sclerosis.

They do this at home, school and work. In most places, there are no biohazard containers on the walls and no special trucks picking up the used, contaminated syringes and other medical waste as is done in hospitals and doctors' offices.

While the state recommends that patients dispose of used syringes in sealed plastic containers, there is no mandate for them to do so and the needles, sealed or not, still end up in the regular trash.

Complicating matters are the different regulatory guidelines for the same household "biohazardous" waste, depending on whether or not it's labeled as such, along with a scarcity of options for patients who want to dispose of their devices in a safe and environmentally friendly manner.

Shannon Presti, 35, of Doylestown Township, uses a syringe to deliver treatment for her MS. An artist and photographer, Presti takes a potent intravenous drug each day to control her symptoms. She is going public with her condition to alert people that Pennsylvania has no law regarding the safe disposal of used syringes, or "sharps."

According to the federal Food and Drug Administration, more than 3 billion needles and other sharps are used each year by 9 million people in homes throughout the United States.

Lynda Rebarchak, community relations coordinator for the Pennsylvania Department of Environmental Protection, confirmed the state has no policy on household biohazardous material, except when the material is in a container marked "biohazard." Those must be disposed of with other biohazardous material and not in the regular trash stream.

The containers that Presti stores her needles in were provided by the drug company and marked "biohazard." She was unsuccessful in finding disposal options for those containers, however.

"We have no regulations relating to the residential disposal of home health care waste — including needles, or sharps — but do offer guidelines," Rebarchak said.

The DEP recommends that people put the sharps in a "puncture-resistant, hard plastic container" (such as an empty laundry detergent bottle with a screw-on cap). When the container is filled, it should be closed tightly and secured with heavy tape, placed in a paper bag and discarded with household trash," according to an Allegheny County Health Department website that Rebarchak referenced.

The container should not be put into a recycling bin, even though it is plastic.

New Jersey recommends that patients dispose of sharps in the same way.

"Sharps generated from home use by patients are exempted from our regulated medical waste regulations," said Larry Ragonese, a spokesman for the New Jersey Department of Environmental Protection. "Some patients will contact hospitals, doctor offices or pharmacies to see if these entities will take these home-use generated sharps to be disposed with the entity's own used sharps."

But Presti could not find a medical center to take her sharps.

Everyone she called — hospitals, police departments, doctor's offices — told her to put the needles in a detergent or bleach bottle since that is allowed in the regular trash collection.

She doesn't feel right about doing that. What if a bottle falls to the street or gets cracked during trash collection and the needles fall out?

"I'm sure a lot of people with these medical [conditions] will do that because that's what they've been told to do, whether it's the right thing to do or not," Presti said.

George Garber, an infection control prevention specialist at Lower Bucks Hospital in Bristol, said he doesn't advertise that the hospital accepts sharps. He once got a call from a local Marine Corps recruiting station asking if the hospital could dispose of the syringes the Marines used to test the blood of new recruits. When he said yes, the Marines showed up with 16 boxes full of sharps they had stored for a long time because they didn't know how to dispose of them, he said.

Presti anticipates she will be taking Copaxone, the injected drug that holds her MS symptoms at bay, for the rest of her life. Taking it each day has generated hundreds of sharps that need proper disposal.

Presti figures there are thousands of people throughout the state with medical conditions for which they need to take injected drugs. "It freaks me out — the amount of needles," she said. "There's got to be a better way to reuse them, recycle these."

In 2011, the federal Environmental Protection Agency posted advice for how to dispose of medical waste at home or while traveling.

"With more diseases and conditions such as diabetes, cancer, allergies, arthritis and HIV being managed outside of hospitals and doctors' offices, the number of sharps used in homes and work offices is increasing. In addition, pets are being treated in homes and livestock are being treated on farms, which are also contributing to the increased number of sharps outside of veterinary hospitals," the EPA stated. The agency urged people to use hard plastic detergent bottles for disposal or take the waste to a biohazard collection site in their state. It also reminded them to take a portable collection bottle with them to work or if they travel.